MEDICARE: DR. RICHARD BLACKWOOD GRUNDY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401008590	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0401008590	OTHER	VA	DENTAL LICENSE

General Provider Information

NPI Number	:	1396810537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD BLACKWOOD GRUNDY D.D.S.

Provider Business Mailing Address
First Line	:	1805 LASKIN RD
Second Line	:	SUITE 100
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4538
Country	:	US
Telephone Number	:	757-321-1870
Fax Number	:	757-963-0468

Provider Business Practice Location Address
First Line	:	1805 LASKIN RD
Second Line	:	SUITE 100
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4538
Country	:	US
Telephone Number	:	757-321-1870
Fax Number	:	757-963-0468

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1275769432 — DR. JACOB LEE SAXTON DDS
Practice Location Address:

1805 LASKIN RD , #100
VIRGINIA BEACH, VA
23454-4538

Practice Phone: 757-321-1870
Practice Fax: 757-963-0468

1285997478 — JACOB L. SAXTON, DDS, PC
Practice Location Address:

1805 LASKIN RD , #100
VIRGINIA BEACH, VA
23454-4538

Practice Phone: 757-321-1870
Practice Fax: 757-963-0468

1568497519 — DR. LARRY MARK WEISENTHAL MD., PHD.
Practice Location Address:

16512 BURKE LANE
HUNTINGTON BEACH, CA
92647-4538

Practice Phone: 714-596-2100
Practice Fax: 714-596-2110

1629257860 — WEISENTHAL CANCER GROUP
Practice Location Address:

16512 BURKE LANE
HUNTINGTON BEACH, CA
92647-4538

Practice Phone: 714-596-2100
Practice Fax:

1821430018 — KRISTIN GILLESPIE
Practice Location Address:

513 SHORE RD
LONG BEACH, NY
11561-4538

Practice Phone: 516-305-0974
Practice Fax:

1205239795 — BRIAN COOPER CRISTIANO M.D.
Practice Location Address:

16512 BURKE LN
HUNTINGTON BEACH, CA
92647-4538

Practice Phone: 909-252-7181
Practice Fax: 909-345-2086

Directions to “ DR. RICHARD BLACKWOOD GRUNDY D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.